Examples of Early Intervention Demonstrations David A. Weaver Office of Research, Demonstration, and Employment Support, SSA February 12, 2015
Introduction ● The President’s budget requests resources for SSA to support early intervention demonstrations ● Partnership among Federal agencies ● Demonstrations will focus on populations that may be at risk of ending up on disability benefits ● Services will be designed to help individuals with disabilities remain in the workforce ● Rigorous experimental design and evaluation will produce an evidence base for potential program innovations 2
Rationale for Early Intervention ● Early intervention, before an individual fully detaches from the labor force, may be more effective ● Health and earnings often begin to decline well before complete disability onset or receipt of DI benefits ● CMS’s Demonstration to Maintain Independence and Employment (DMIE) showed some success ● Further testing of early intervention strategies is needed 3
Approach ● Examined proposals in the literature and consultation among federal partners ● Examined prior demonstrations and research to understand logistics, participation, costs, and potential outcomes ● Used available data so design is evidence- based using the latest information 4
Design: Initial Demonstration ● Provision of services: medical-vocational services ● Focused on identifiable and scalable populations ● Focus on population age 18-49 with mental illness 5
What Services Could be Provided? ● Several models to draw from: ● Mental Health Treatment Study ● Recovery After Initial Schizophrenia Episode (RAISE) Study ● Individual Placement and Support with Recent-Onset Schizophrenia 6
What Populations Could be Served? ● Population age 18-49 with mental illness ● 13M SSI disabled or SSDI are currently on the rolls ● 2.6M are age 18-49 with a mental illness ● Denied applicants and VR participants not on SSI/SSDI ● Denied SSI/SSDI applicants ● Non-beneficiaries receiving VR services 7
Bigger Picture ● President’s budget calls for funding of more than one type of demonstration ● One example: financial incentives to businesses for successfully retaining workers with health problems ● Another example: expand vocational services to participants in Health Homes 8
Discussion 9
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